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DOI: 10.1055/s-2004-814124
Complete Spontaneous Submucosal Dissection of the Sigmoid Colon
C. de la Serna-Higuera, M. D.
Unidad de Digestivo
Hospital ”Virgen de la Concha”
Avenida de Requejo 31-33
Zamora 49002
Spain
Fax: + 34-980-548-221
Email: csernah@hotmail.com
Publication History
Publication Date:
14 January 2004 (online)
Figure 1 A 73-year-old woman presented with cramps and scant hematochezia. She was otherwise healthy. There was no history of prior illness, drug ingestion, trauma, or foreign-body introduction. The physical examination only showed a large, membranous structure protruding through the anal canal. Laboratory values were within normal limits. Flexible sigmoidoscopy revealed markedly erythematous, swollen sigmoid mucosal sloughing, involving almost one-third of the lumen at this level.
Figure 2 When the sigmoidoscope was removed, the patient expelled a 42-cm long, sausage-like cylindrical structure.
Figure 3 Another rectosigmoidoscopy was performed, showing the lower margin of mucosal dissection at the rectosigmoid junction, circumferential in shape, with well-defined borders and a residual mucosal flap.
Figure 4 Histopathological evaluation of the specimen after longitudinal incision and cleaning of fecal debris showed normal intestinal epithelium, with connective tissue and scattered inflammatory cells in the lamina propria.
C. de la Serna-Higuera, M. D.
Unidad de Digestivo
Hospital ”Virgen de la Concha”
Avenida de Requejo 31-33
Zamora 49002
Spain
Fax: + 34-980-548-221
Email: csernah@hotmail.com
C. de la Serna-Higuera, M. D.
Unidad de Digestivo
Hospital ”Virgen de la Concha”
Avenida de Requejo 31-33
Zamora 49002
Spain
Fax: + 34-980-548-221
Email: csernah@hotmail.com
Figure 1 A 73-year-old woman presented with cramps and scant hematochezia. She was otherwise healthy. There was no history of prior illness, drug ingestion, trauma, or foreign-body introduction. The physical examination only showed a large, membranous structure protruding through the anal canal. Laboratory values were within normal limits. Flexible sigmoidoscopy revealed markedly erythematous, swollen sigmoid mucosal sloughing, involving almost one-third of the lumen at this level.
Figure 2 When the sigmoidoscope was removed, the patient expelled a 42-cm long, sausage-like cylindrical structure.
Figure 3 Another rectosigmoidoscopy was performed, showing the lower margin of mucosal dissection at the rectosigmoid junction, circumferential in shape, with well-defined borders and a residual mucosal flap.
Figure 4 Histopathological evaluation of the specimen after longitudinal incision and cleaning of fecal debris showed normal intestinal epithelium, with connective tissue and scattered inflammatory cells in the lamina propria.